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Biomedical subjects

S C Ho

Publications and source records attributed to S C Ho.

At least 91 records · Page 5Linked to original sources
PubMed1996

Risk factors for falls in the Chinese elderly population.

BACKGROUND: Besides being the major cause of hip fracture, falls also have important consequences in injuries and mortality, especially in the elderly population. This study investigated the occurrence of and the correlates of falls in a cohort of Hong Kong Chinese elderly aged 70 years and above. METHODS: The research was based on the baseline cross-sectional study of an age- and sex-stratified cohort consisting of 1,947 ambulatory subjects. The occurrence of falls was based on the previous 12 months. Logistic regression analysis was used to test the effect of each independent variable, adjusting for age and sex. Multivariate logistic regression analysis based on the backward elimination procedure was used for the final model. RESULTS: Previous white-collar employment, poor self-perceived health, dizziness, slow gait velocity, difficulties in activities of daily living, non-practice of "morning walk," body mass index in the range of 20-24, use of local skin preparation, and presence of cerebrovascular disease were independently associated with falls. Smokers were found to have an independent decreased risk of falls. Neither age nor sex was significantly associated with falls after adjusting for the other explanatory variables. CONCLUSIONS: The results from this population-based cross-sectional study form a basis for further prospective study on falls in the Chinese elderly population. Both intrinsic and extrinsic factors including circumstances and consequences of falls are important considerations in the strategy for the prevention of falls.

Accidental Falls↗
PubMed1996

Tuberculosis among elderly Chinese in residential homes: tuberculin reactivity and estimated prevalence.

Objectives of this study were to determine the prevalence of positive tuberculin reactivity and associated factors among elderly nursing home residents in a population with a relatively high tuberculosis notification rate, to estimate the prevalence of active tuberculosis, and to assess tuberculin reactivity as a screening tool. A stratified, disproportional, randomized cluster sample of residents was selected and the Mantoux test (using 0.1 ml of 5 tuberculin units of purified protein derivative of tuberculin) carried out. All subjects with a positive test had a chest X-ray followed by sputum smear and culture if the X-ray was abnormal. Sputum examination was also carried out in a random sample of controls, matched for age and gender, drawn from subjects with a negative Mantoux test. Information regarding medical history, tobacco smoking habits, symptoms related to tuberculosis, and communal eating habits were gathered. Also anthropometric data were collected. Sixteen nursing homes in the catchment area of a major district hospital in Hong Kong comprising 587 residents (136 men, 451 women, mean age 80 +/- 8 years) participated in this study. The weighted prevalence of tuberculin reactivity was 43.8%. It was higher in men, among those who took their meals in a common area, in the younger age group, and in those with no previous history of hospitalization. No association was found between prevalence and duration of residence, smoking, skinfold thickness, past medical history, or any relevant symptoms. Following radiological and sputum examination, the estimated prevalence of active tuberculosis ranged from 1.2 to 2.6%. The sensitivity of the tuberculin test was 86, the specificity 30%. The prevalence of active tuberculosis in nursing homes in Hong Kong is high, but it is unclear whether cross-infection or poor health of the residents is the major contributing factor. Tuberculin skin testing does not appear to be a useful screening method in this population.

Aged↗
PubMed1996

An estimation of the functional disability burden in elderly Chinese age 70 years and over.

A cross-sectional survey of functional status among elderly Hong Kong Chinese aged 70 years and over was carried out to estimate the current burden of disability. Two thousand and thirty-two subjects (999 men, 1033 women) were recruited by random sampling of the old age and disability allowance schemes covering over 90% of the elderly population, stratified by sex and 5-year age groups. Functional ability was administered using the Barthel Index. The duration of disability, if any, was also noted. The prevalence of disability for different activities of daily living varied from 0.8% to 26% (lowest for feeding and highest for climbing stairs and bathing). The prevalence was higher for women than men, and higher in the older age group for both sexes. Men in the 80+ age group had shorter duration of disability compared with those in the 70-79 age group, and compared with women. Using disability years (estimated number of elderly with disability in the population x median duration of disability) as an estimate of disability burden, the number ranges from approximately 19,000 (inability to feed) to 100,000 (inability to climb stairs). This estimate may be useful in the planning of service provisions for the formal and informal care sector.

Activities of Daily Living↗
PubMed1996

Body measurements, bone mass, and fractures. Does the East differ from the West?

There are population differences in hip fractures between the East and West. The hip fracture incidence in Asians is approximately 40% to 50% of that in whites in the United States. There also are differences in body measurements and bone mass between the population groups. This article discusses the role of body measurements in relation to bone mass and bone loss at different stages of life and interrelationship of these variables with fracture risks.

Accidental Falls↗
PubMed1995

Differential effects of anti-B7-1 and anti-B7-2 monoclonal antibody treatment on the development of diabetes in the nonobese diabetic mouse.

Insulin-dependent diabetes mellitus (IDDM) is thought to be an immunologically mediated disease resulting in the complete destruction of the insulin-producing islets of Langerhans. It has become increasingly clear that autoreactive T cells play a major role in the development and progression of this disease. In this study, we examined the role of the CD28/B7 costimulation pathway in the development and progression of autoimmune diabetes in the nonobese diabetic (NOD) mouse model. Female NOD mice treated at the onset of insulitis (2-4 wk of age) with CTLA4Ig immunoglobulin (Ig) (a soluble CD28 antagonist) or a monoclonal antibody (mAb) specific for B7-2 (a CD28 ligand) did not develop diabetes. However, neither of these treatments altered the disease process when administered late, at > 10 wk of age. Histological examination of islets from the various treatment groups showed that while CTLA4Ig and anti-B7-2 mAb treatment blocked the development of diabetes, these reagents had little effect on the development or severity of insulitis. Together these results suggest that blockade of costimulatory signals by CTLA4Ig or anti-B7-2 acts early in disease development, after insulitis but before the onset of frank diabetes. NOD mice were also treated with mAbs to another CD28 ligand, B7-1. In contrast to the previous results, the anti-B7-1 treatment significantly accelerated the development of disease in female mice and, most interestingly, induced diabetes in normally resistant male mice. A combination of anti-B7-1 and anti-B7-2 mAbs also resulted in an accelerated onset of diabetes, similar to that observed with anti-B7-1 mAb treatment alone, suggesting that anti-B7-1 mAb's effect was dominant. Furthermore, treatment with anti-B7-1 mAbs resulted in a more rapid and severe infiltrate. Finally, T cells isolated from the pancreas of these anti-B7-1-treated animals exhibited a more activated phenotype than T cells isolated from any of the other treatment groups. These studies demonstrate that costimulatory signals play an important role in the autoimmune process, and that different members of the B7 family have distinct regulatory functions during the development of autoimmune diabetes.

Abatacept↗
PubMed1995

Determinants of bone mass in the Chinese old-old population.

One hundred and eighty-eight elderly men and women were included in a study of bone mass at the neck of femur and its related factors. The study subjects were a subsample of a Hong Kong wide study of the elderly population aged 70 years and above. The study variables included age, sex, body measurements of height, weight, body mass index, dietary calcium intake, grip strength, 16 feet (5 m) gait speed, smoking, drinking, and years since menopause among women. The neck of femur bone mineral density among elderly men was about 1 standard deviation higher than that of women. Subjects aged 85 years and above had about 20% lower bone mineral density at the neck of femur when compared with those in the age group 70-74 years. Mean dietary calcium intake ranged between 300 and 430 mg/day and was not associated with bone mass. Multiple regression analysis showed that body weight, 16 feet gait speed, sex and alcohol consumption explained 46% of the total variance of femoral neck bone mineral density. Body weight was the most significant predictor of bone mineral density, with a partial correlation coefficient of 0.5. The maintenance of body weight within the acceptable weight range and promotion of physical fitness may be important measures in reducing bone loss in the elderly population.

Aged↗
PubMed1995

Life satisfaction and associated factors in older Hong Kong Chinese.

OBJECTIVE: To determine life satisfaction and its association with physical, functional, socioeconomic, psychological, and social support characteristics in Hong Kong Chinese aged 70 years and older. DESIGN: Cross-sectional study. SETTING: Territory-wide random sample of persons aged 70 years and older. SUBJECTS: A total of 843 men and 714 women were selected by random sampling, stratified by age and sex, from the Old age and Disability Allowance Register, after exclusion of subjects with cognitive impairment. MEASUREMENTS: Life satisfaction was assessed by the subjects' response to the question "Are you satisfied with life", using a 0 to 10-point linear scale. They were also asked to name the most important factor contributing to life satisfaction. Information was also obtained regarding physical health, functional ability, depressive symptoms, and socioeconomic factors. RESULTS: There was a weak association between score and age. Health, adequate income to meet living expenses, and caring relatives were rated the most important factors (> 65%). Some of these factors were also those associated with a high life satisfaction score. Factors associated with a life satisfaction score greater than 6 points were higher social class and educational attainment, adequate income to meet living expenses, satisfactory living arrangement, Christianity, good social support, participation in social activities, functional independence, good self-perceived health, good hearing and vision, daily exercise, absence of recurrent falls, and low depressive symptom score. Multiple logistic regression identified having two or more relatives and tertiary education as positive associated factors, whereas inadequate income to meet expenses, dissatisfaction with living arrangement, nonparticipation in religious group activities, and a high depressive symptom score were negative associated factors. CONCLUSION: In older Chinese, social factors such as the support provided by family members, as well as adequate income to meet living expenses, play a role equal to that of physical factors in contributing to life satisfaction.

Age Factors↗
PubMed1995

Age-associated gait changes in the elderly: pathological or physiological?

AIM: To examine the role of disease-related factors and age-related physiological changes in affecting gait speed and stride length in the elderly. SUBJECTS: 925 men and 890 women aged 70 years and above who were ambulant, recruited by random sampling stratified according to age and sex, from all recipients of Old Age and Disability Allowance in Hong Kong. DESIGN: Gait was assessed by measuring the time taken and the number of steps required to complete a 16-foot walk. Information on health and functional status, cognitive function, and depressive symptoms was collected, and anthropometric indices obtained. Factors affecting walking speed and stride were examined in the overall population and also after excluding those with physical disability or diseases. RESULTS: Results were analyzed separately for men and women since mean walking speed was slower in women, who also took a larger number of steps. Age, coexisting disease, leg or back pain, poor vision, low level of physical activity, functional and cognitive impairment, high depressive symptom score, and anthropometric indices were all negatively associated with walking speed. Fallers also had slower speed. After excluding those with diseases or physical impairment, multivariate analysis showed that the only factors affecting speed were age in men, and age, height, and level of physical activity in women. Age and height were factors associated with stride length in men, and height only for women. CONCLUSION: Both disease-related factors as well as age-related physiological changes contribute to the decline in walking speed and stride length.

Age Factors↗
PubMed1995

Drug use in an elderly Chinese population: prevalence and associated factors.

This study examined the pattern of drug use in an elderly population aged 70 years and over, and the factors associated with drug use. The study population was selected by stratified random sampling of all registered recipients of Old Age and Disability Allowance in Hong Kong. 997 men and 1,035 women were interviewed as part of a survey on physical, functional, mental health and social status of the elderly in Hong Kong. 71% of the sample took drugs, the prevalence being higher in women. The most common drugs taken were antihypertensives, skin preparations, vitamins and minerals, other cardiovascular drugs, antacids or H2 antagonists, and non-steroidal anti-inflammatory analgesics (all over 10%). Overall, 66% were using medications that were unlabelled. Factors associated with drug use that were examined included socioeconomic factors, educational level, physical health, cognitive function, depressive symptoms, functional ability, life satisfaction, and living arrangements. Multivariate analysis using forward stepwise logistic regression showed that the use of prescription drugs was associated with the presence of chronic disease, poor self-perceived health and being female. Use of > 5 drugs was associated with similar factors: presence of chronic disease, being female, and residence in institutions. The factors for use of non-prescription drugs were different: living in the community, presence of joint pain restricting activities, dissatisfaction with living arrangements, and age. Reducing the number of unlabelled drugs, restricting access to non-prescription drugs, improving access to doctors and patient education all might well be important measures in improving the therapeutic needs of this elderly population.

Age Factors↗
PubMed1995

Influence of age, disease and disability on anthropometric indices in elderly Chinese aged 70 years and above.

To determine the influence of age, disease and other factors on anthropometric indices in elderly subjects aged 70 years and above, body mass index (BMI), arm muscle circumference (AMC), corrected arm muscle area (CAMA), fat-free mass (FFM) and total body fat (TBF) were determined in a random sample of 990 Chinese men and 1,021 women aged 70 years and over stratified by age and sex. Old age, presence of disease, poor self-perceived health, poor functional ability, lower level of physical activity, lack of dentures, depression and cognitive impairment were all factors associated with lower anthropometric values. Haemoglobin, total cholesterol and walking speed were also associated factors, although the latter two factors became insignificant after adjusting for age. When subjects with a history of disease or cognitive impairment were excluded, an age-related decline in BMI, AMC, CAMA and TBF was still observed in men although FFM remained unchanged. However, in women, only TBF showed an age-related decline. It is concluded that in the old-old population, both age and disease affect anthropometric indices, the change being more marked in men.

Adipose Tissue↗
PubMed1995

Respiratory symptoms in elderly Chinese living in Hong Kong.

Respiratory diseases can cause considerable disability in the elderly because of their limited respiratory reserve as a result of ageing. We have investigated the prevalence of respiratory symptoms and diseases in elderly Chinese in Hong Kong and compared these data with those in elderly Caucasian populations. Two thousand and thirty two (999 male and 1,033 female) subjects, selected by age-stratified random sampling from a register of Hong Kong residents aged 70 yrs and over were interviewed to complete a respiratory questionnaire. Total serum immunoglobulin E (IgE) was measured in 195 subjects. At least one respiratory symptom was reported by 56% of subjects. The most frequently reported symptoms were morning phlegm (26%), chronic cough with phlegm (10%) and wheeze in the past 12 months (8%). Of the self-reported diseases, the commonest was chronic bronchitis (7%), followed by asthma (5%), pulmonary tuberculosis (3%) and emphysema (2%). Of the 218 subjects with obstructive airway diseases, 128 (59%) had sought medical advice in the past 12 months. The most important determinants for respiratory symptoms and diseases were smoking and social class. Total serum IgE was significantly higher in current smokers than nonsmokers and also in those with chronic cough and phlegm than those without these complaints. Our study shows that respiratory ailments in Hong Kong elderly are as common as those reported in Sweden and the USA but less than those in England.

Aged↗
PubMed1994

Determinants of serum 1,25-dihydroxyvitamin D concentration in healthy premenopausal subjects.

Concentrations of serum phosphate and parathyroid hormone (PTH) are well known regulators of the production of 1,25-dihydroxyvitamin D (1,25-(OH)2D) and acidosis is known to affect the serum concentration of 1,25-(OH)2D. However, the factors that play a role in the regulation of serum 1,25-(OH)2D concentration in healthy subjects have not been fully evaluated. The associations of ionised calcium, pH, serum concentration of phosphate, PTH, 25-hydroxyvitamin D (25-OHD) and serum 1,25-(OH)2D were examined in 296 healthy premenopausal women (age range 17-40 years). Calculation of partial correlation coefficients showed that serum 1,25-(OH)2D was significantly correlated with phosphate (r = -0.148, P < 0.01), pH (r = 0.221, P < 0.001) and PTH (r = 0.136. P < 0.01). Ionised calcium was not related to serum 1,25-(OH)2D. When the results were stratified according to quartiles based on serum 1,25-(OH)2D concentration, significant trends (by analysis of variance) were seen in phosphate, pH, age, albumin and 25-OHD. Stepwise multiple regression analysis showed that phosphate and pH were the major contributors of serum 1,25-(OH)2D levels. There was a small contribution from PTH and 25-OHD. The results suggest that in young healthy premenopausal women plasma phosphate and pH may be important determinants of serum 1,25-(OH)2D concentration.

Adolescent↗
PubMed1994

Carbohydrate binding activities of Bradyrhizobium japonicum: IV. Effect of lactose and flavones on the expression of the lectin, BJ38.

BJ38 is a galactose/lactose-specific lectin (M(r) approximately 38,000) found at one pole of Bradyrhizobium japonicum. It has been implicated in mediating the adhesion of the bacteria to soybean roots, leading to the establishment of a nitrogen-fixing symbiosis. When the ligand lactose is added to cultures of the bacteria for at least 1 h prior to harvesting the cells for BJ38 isolation, the yield of the protein was found to be elevated in a dose-dependent fashion. Half maximal stimulation was observed at approximately 50 microM; the effect was saturated at approximately 1 mM, where a 10-fold higher yield of BJ38 was obtained. Saccharides with a lower affinity for BJ38 than lactose yielded a correspondingly smaller induction effect when compared at a concentration of 1 mM. The higher level of BJ38 induced by lactose is also manifested by an elevated amount of BJ38 detectable at the cell surface and by a higher number of B. japonicum cells adsorbed onto soybean cells. Surprisingly, the induction of BJ38 expression seen with lactose was also observed with certain, but not all, flavonoids that induce the nod genes of the bacteria; genistein mimicked the induction observed with lactose, whereas luteolin failed to stimulate BJ38 production.

Carbohydrate Metabolism↗
PubMed1994

Determinants of bone mass in Chinese women aged 21-40 years. II. Pattern of dietary calcium intake and association with bone mineral density.

A study on the determinants of bone mass in young women is being carried out among 287 young Chinese women aged 21-40 years. The baseline cross-sectional data show that the mean dietary calcium intake, estimated from the quantitative food frequency method, was 448 mg/day (standard deviation = 219). About 50% of the calcium source was from vegetables and 22% from dairy products. Among women aged 21-30 years, those with a dietary calcium intake of at least 600 mg/day had a 4%-7% higher mean bone mineral density at the spine and femur when compared with those with a mean intake below 300 mg/day. In women aged 31-40 years, subjects belonging to the highest quartile of calcium density (> or = 35 mg/420 kJ) had a 3%-8% higher mean bone mineral density at the spine and femur when compared with those in the lowest quartile (< 20.8 mg/420 kJ). Favorable calcium intake is beneficial in this population of young women with habitual low dietary calcium intake.

Adult↗
PubMed1994

Risk factors for acute myocardial infarction in a southern Chinese population.

Although the mortality rate from coronary artery disease in Hong Kong is only one-fourth of that of northern Europe and the United States, the disease has been and remains the second major cause of death (after all cancers combined). Beginning in 1987, we have conducted a case-control study of acute myocardial infarction in four Hong Kong hospitals. This study, one of the biggest case-control studies conducted in the Chinese population of both men and women, confirms the importance of several risk factors--cigarette smoking, history of hypertension, history of diabetes, body fatness, and lack of physical activity--previously described in data collected in western populations. In addition, more adverse childhood experience was also found to be an important risk factor of acute myocardial infarction. Further research in appropriate intervention measures in education in the prevention and cessation of smoking, the control of blood pressure, diabetes, and overweight, and adequate exercise could significantly help reduce the risk of acute myocardial infarction in the Hong Kong Chinese population.

Aged↗
PubMed1994

Carbohydrate binding activities of Bradyrhizobium japonicum. III. Lectin expression, bacterial binding, and nodulation efficiency.

In previous studies, evidence that the Bradyrhizobium japonicum lectin, designated BJ38, mediated the observed carbohydrate-specific binding activities of the bacteria, including the saccharide-specific adhesion to soybean root cells was presented. In the present study, it is found that both B. japonicum, as well as the purified BJ38, bind predominantly to young emergent root hairs of soybean roots and, to a much lesser extent, to the root cap, mature root hairs, epicotyl or hypocotyl regions. Thus, the region of preferential binding for both the bacteria and the isolated lectin coincide with the region of the soybean root most susceptible to B. japonicum infection. The importance of bacterial binding for the nodulation process was studied by comparing the nodulation efficiency of binding-deficient mutants N4 and N6 to the wild-type. These mutants had been shown to be defective in carbohydrate recognition, as represented by their diminished ability to bind to soybean roots. BJ38 was immunolocalized to one pole of the cell surface of wild-type B. japonicum, but no surface labeling could be detected on either mutant. Moreover, both N4 and N6 showed a substantial decrease in nodulation activity, relative to the wild-type. These results provide additional evidence that the carbohydrate binding activity of B. japonicum, most probably mediated by BJ38, may play an important role(s) in the initial phases of the infection process.

Bacterial Adhesion↗
PubMed1994

Nutritional status of elderly patients during recovery from chest infection and the role of nutritional supplementation assessed by a prospective randomized single-blind trial.

We examined changes in the nutritional status of elderly patients with chest infection for a period of 3 months after discharge from hospital, including the effects of nutritional supplementation on well-being and functional status as well as on nutritional indices. Eighty-one subjects admitted to an acute medical ward aged 65 years and over with chest infection were recruited consecutively, and randomized to receive supplement (500 ml of Ensure liquid daily) for 1 month, or no supplement, on discharge. Assessment at baseline, 1, 2 and 3 months included a questionnaire to determine health, mental and functional status, and anthropometric measurements. Biochemical nutritional status was assessed at baseline, 1 and 3 months, and dietary intake (24 h recall method) at 1 and 3 months. During recovery, both supplement and non-supplement groups showed improvement in various measures of well-being and biochemical status. In addition, the former group showed improvement in more anthropometric measurements, in thiamine and pyridoxine status, while the non-supplement group showed a lower level of functional ability after 3 months. Various measures of well-being and biochemical status of the water-soluble vitamins were better in the supplement groups. We conclude that nutritional supplementation may have a role in helping elderly patients to recover from chest infections.

Aged↗